Factors influencing ceftriaxone use in community-acquired pneumonia: Emergency doctors’ perspectives

Objective: To explore the perceptions of ED doctors regarding the use of ceftriaxone in patients with community-acquired pneumonia (CAP).

Methods: Face-to-face interviews were conducted with ED doctors in an Australian tertiary public hospital. A semi-structured interview method was used for collecting data and a framework analysis approach utilised to identify emerging themes regarding the influences on ED prescribers when using ceftriaxone for CAP.

Results: Eight interviews were performed (two consultants, four registrars and two residents). Five main themes emerged as influencing decisions regarding the selection of ceftriaxone for patients with CAP: (i) clinical intuition versus structured evaluation of severity; (ii) clinical uncertainty; (iii) prior experience; (iv) source of guidance; and (v) prescribing etiquette.

Conclusion: As most cases of CAP are initially diagnosed and treated empirically in the ED, any interventions that aim to decrease inappropriate use of ceftriaxone for CAP should address the factors identified here that influence ED doctors’ prescribing decisions.